Nasheed on “druggies”, the antisocial and all the brouhaha from me (Part 1) June 7, 2007

Nasheed, in his blog mentioned the importance of an integrated approach when looking at substance abuse. My comments in brackets below.

Root cause of many issues is inevitably being linked to substance abuse (i think not..this is just another lame attempt by some one to make a vulnerable group from society being labelled as the “BEAST”). It is dawning on us all that enforcement alone is not working (that is right :)). A wholesome and integrated approach including rehabilitation, penalty, reintegration, community support, policy decisions, enforcement techniques, monitoring and supervision mechanisms, control of borders and tackling anti social behavior in a big way would all need to be included in our approach to fight this deadly (i think this word is too graphic to use here) reality.

I cant agree more on an integrated approach. Unavoidably and explicitly, the words “anti-social” began ringing several bells in my head. I will try to tell a little on what i know about anti-social behaviours. Please allow me.

In short antisocial means “against the society”. No arguing about that. Unacceptable social behaviour or antisocial behaviour among children, adolescents and adults is a much talked about subject. History proves that during different times, different labels had been given to this category of people who showed a certain type of trait or behaviours. When talking about antisocial behaviour, morals and responsibility come in to the picture and thats where this whole subject gets messy. Hold on. I am getting there. Or at least i will try.

The first description of antisocial behavior was known to be mentioned during 1853. In 1853 it was possibly then known as “moral insanity”. It is known that in 1843, what is known as the M’Naghten rule, ruled out a person from getting punishment if the person is not aware of the crime. In 1887, a person was found not responsible for a crime if the person lost the power to choose between right and wrong. In 1941 a person displaying antisocial aspects was depicted as “the mask of sanity”. Like the M’Naghten rule, in 1954 a Durham rule stated that a person was not responsible if the act was a product of mental disease or mental defect and in 1978 the rule of diminished capacity came in to being, giving the mentally disordered criminal guilty to a lesser extent.

There is a reason for me in mentioning all that.

1. Antisocial behaviour is on the rise in our country.

2. Majority of population is young.

3. How many of those “anti-socials” will fit in to the category of a psychiatric illness or disorder?

4. How many does fit in to the antisocial personality disorder (ASPD) type as categorised in the DSM IV.

I know the religious fanatics and some others will be going crazy by now, if they are reading this. They will be saying to themselves that morality and responsibility is a religious issue. Well, let them say what ever they want. Maldiveshealth is dedicated to the special ones in the society for the year of 2007 and where ever, and however i can, i would like to create awareness on the injustice being brought to the vulnerable groups in our society.

DSM IV describes ASPD as “a pervasive pattern of disregard for, and violation of the rights of others that begins in childhood or early adolescence and continues into adulthood”. This pattern has also been referred to as psychopathy, sociopathy or dissocial personality disorder. To fit in to the DSM IV criteria, the individual with ASPD has to be over 18 years of age. They display aggression towards animals and people, destruction of property, deceitfulness or theft and involves in serious violation of rules. They also repeatedly performs these acts with disregard to feelings of others, they are manipulative in order to profit personal pleasures (obtain money, sex, power). They make decisions on the moment without forethought and without consideration for the consequences to self or others. People having ASPD are irritable and aggressive, involves in physical fights , spouse beatings, child beatings, which are common practices. Furthermore, the DSM IV describes them as extremely irresponsible, who fail to make amendments or compensate for their behaviours, have a lack of empathy, callous, cynical and contemptuous of the feelings of others. ASPD is more common in Males (3%) than females (1%). ASPD can occur together with other personality disorders like narcissistic PD, Histrionic PD, Borderline PD, Paranoid PD . The highest prevalence age category recognized as having ASPD is among the adolescent age group. Understanding adolescent delinquency requires understanding adolescents themselves. In doing so we can’t neglect the environment and biology of the adolescent youth in understanding delinquency and antisocial behaviour among this age group.

There is much debate regarding the predisposing factors to ASPD. One of the strong influences comes from geneticist gurus supporting a relationship between genes and ASPD. One such view states that a “disinhibition-disorder gene carried by a parent could result in marital chaos and separation and that it is this inherited gene and not the fact that the parents separated that causes antisocial personality in the child” (I know ..i know.. the religious freaks will be going even more crazier now. Just hold on and tolerate this post will ya). Identifying the responsible gene hence is much more economically viable and could identify high risk individuals and thus treat them before things got out of hand. The geneticist gurus dispute the social causations totally, and solely base their assumptions on genetics. Some studies done in Denmark, Sweden and the US on ASPD and criminality shows only moderate genetics being influential as measured by characteristics of biological parents. Some may argue saying that it is too early to link antisocial behaviour, illegitimacy, or intelligence with genetics as it is only the beginning of the Genome Project. I think it may give a very justifiable and viable answer to a very big problem.

How ever, there are other predicaments which may arise from genetic labelling such as the controversy and dilemma parents has to face if they found out that their child is having an extra Y chromosome. There might be unalterable implications for children of the stigma the children might have to face with genetic labelling. It is also questionable whether violent television, violent cartoons, violent movies and ready access to guns (in US), ready access to heroin (in Maldives) are having any impact on a child becoming aggressive and later on in showing antisocial behavior. Does these social factors outweigh the possible genetic factors? There is more support toward the environmental and upbringing aspects of children and the link between ASPD in adolescents. With the decline of genetic influences, environmental factors become more influential.

……………………..(Part two coming soon)….